Oncology I & II Flashcards by c asos

What are the risk factors for cancer?

Tobacco &amp; Alcohol
Nitrates 
Increased Meat / Fat 
Obseiity
Immunosupressed 
Herederity 
Africans > Caucasians 
Lack of sunscreen use

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Prevention and Screening

No smoking 
Limit Red Meat 
Have a good diet 
Wear Sunscreen 
Vaccines

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Secondary prevention - Females Curing the cx and treating it

SBEX 7-12 days 2/ Post and Hyst, same day each month
BSE at age 20-39, q1 every 3 yrs,
Mammogram 1 q3 after 50 q1 - nothing on
Polyps/fecal occult/ colonoscopy at 50 unless found something

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Secondary prevention - Males

BSE and TSE yearly
15-36 TS Cx
Digital Rectal Exam at 50 for PSA
Colonoscopy/Fecal occult at 50 q10 years unless something found.

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Tertiary

To provide management of complex complications

Support groups and Rehab

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Diagnosis For Cancer

Changes in bladder and bowel 
A sore that does heal 
Unusual bleeding
Thick lump 
Indigestion or difficulty swallowing 
Obvious change in wart/mole 
Nagging Cough
--
Electrical razors soft brushes 
NO IM quiet play 
#1 sign of Cx is pain
Cachexia 
Fatigue 
Blood problems = Anemia
Constant Fever = Lymphoma

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Blood Tests

CBC Diff (WBC) * Neutrophils
Elevates Liver AST/ALT
Tumor Biomarkers
Regular Diagnostic studies

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Laryngectomy

Remove Epigliottis, Cartilage and Thyroid

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Care for Total Laryngectomy

NPO
Midfowlers 35-45
Ng feeds, watch for peristalsis 
Innate Carotid 
Bib on 
Forever theyll voice box 
NOT ALLOWED - Whistle, drink through a straw, NOT recommended to swim or smoke

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Reconstructive Breast Surgery

#1 Pooling -> where?
Graph site 
Monitor Jackson Pratt/ Hemovac 
No constrictive clothing/BP/Jewelry
Finger wall climbing, Brushing Hair

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Radiation Therapy

Brachytherapy Can cause harm to others Unsealed or sealed

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Unsealed radiation Therapy

Going as close via inside towards the cx, causing harm via bodily fluids
IV/PO
24-48HRS

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Sealed Radition

Implanting close to cx bodily fluids does not cause harm/ not radioactive and is implanted inside
Prostate/ cervical CX.

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General Precautions for Radiation

Time/Distance/ Shielding/

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Precautions with internal radiation

Change the nurse daily and wear a film badge
Private room one client
No children below 16, pregnant
Limit visitors, 6 ft, 30 mins only

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How to help w/ dislodgement for sealed

Decrease fibre
bedrest
prevent bladder distention

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What to do when implant is dislodged?

Wear gloves
Pick it up w/ Forceps
Call Radiation Team

After radiation what are the pts not allowed to do

Have the same toilet w/ everyone must flush
Not sleep in same bed as anyone for 1-11 days
No work / No public transportation
No cooking

External Radiation

Is high beam energy outside the body

External Radiation effects

Is not radioactive
Causes 
Erythemia 
Shedding 
#1! Fatigue

What to teach with externa rad pts?

No lotion
Use sunscreen
Do not remove markings

Chemotherapy

Is to reduce and prevent development of cx.

Full precautions w/ Chemo

Wear a coated gown
Double gloves
Face Shield no Latex

Excretion precautions for Chemo treatment

Chemo excreted for 3-7 days, wear double gloves

Disposal of Chemo

Yellow rigid container and waste bag

What do you do when a spill occurs?

Wash your hands Get spill kit Respirator Gowns/Gloves/Goggles/ Spill

What isextravation?

Complications of chem Chemo drugs given centrally causing vesicants can cause necrosis w/ tissue

S/s of Extravation

Pain | Swelling and No blood return

Txt for extravation?

Stay with client and stop the IV review protocol

Transplants

``` Stem= Blood Bone marrow Both require match Rejection: Abd Pain Pruitis Jaundice Diarrhea ```

GI side Effects of CX

Nausea - Given 1st week of chemo Ondasetron - Zofran given 1hr prior to chemo , rarely causes drowsiness - TRON Nutripitant Oral Combo one dose 1hr before Non pharm Aromatherapy Ginger ale Meditation Stomatitis Oral cavity Diarrhea *1 reason worry about F/E imbalances

Hemapoetic Complications of Chemo

``` Decreased blood cells #1 is worry about infection ```

Integumentary Complications of chemo

Alopecia, allow them to look at the scarring

Pain

There is no ceiling for it | Opiods are gold standard

Neutropenia

Decrease in WBC (ANC count) 2500-8000 | Txt give antibiotics

DVT

``` 2nd leading cause of death Caused by constant bedrest Use of central line Compression of vessels *concern is PE ```

Thrombocytopenia

Clotting factor, platelets are affected

Risk factors for thrombocytopenia

``` Hematological Bleeding disorders Advanced metastatic disease I Purpura/ITP/ hemophilia/liver disease Cx meds Bacterial infections Anticoagulant- aspirin/Coumadin(warfarin) /heparin ```

Thrombocytopenia assessment

``` History Vitals Loc Bleeding/headache/pupils Conjuctival hemorrhage Petchaie/ecchymosis/ purpura oozing from surgical site Bleeding from nose/ mouth/anus ```

Txt for thrombocytopenia

Give platelets

Rbc infusion

If client is symptomatic anemic You do not want below 8gmol Never infuse any blood products cold